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goes unnoticed until it is well advanced. A new Special Focus Issue of the Equine Veterinary Journal (EVJ) aims to help veterinary practitioners improve the diagnosis and treatment of equine dental and sinus disease by bringing together the latest research in this rapidly developing field.
The collection includes 18 papers covering equine dentistry, sinus disease and related conditions. Dental disease is estimated to affect around 93% of horses worldwide and is responsible for between a quarter and two-thirds of equine sinus disease cases. Although these conditions are rarely life-threatening, they can cause chronic pain, poor performance, reduced quality of life and, in severe cases, euthanasia.
Guest editor Tim Barnett notes that dental disease can be surprisingly difficult for owners to recognise. In one study, more than half of the horses examined had moderate to severe dental disease, yet only a quarter of owners had reported concerns about their horse's mouth or teeth. He says the aim of the Special Focus Issue is to make current research readily available so that clinicians can improve diagnosis, treatment and long-term outcomes.
The papers cover a broad range of topics, from basic science through to new surgical techniques. Several studies improve understanding of the biology of dental disease, including research identifying distinctive protein patterns within diseased teeth. These findings may eventually contribute to regenerative treatments that repair rather than simply remove damaged tissue. Another study investigated whether dental procedures cause bacteria to enter the bloodstream, finding no significant increase in bacteraemia following treatment.
Advances in imaging also feature prominently. The increasing availability of standing computed tomography (CT) has transformed the investigation of dental and sinus disorders by allowing detailed assessment with minimal stress for the horse. The issue includes new descriptions of previously poorly understood sinus anatomy, together with case reports demonstrating how CT can assist diagnosis, surgical planning and follow-up.
Several papers describe innovative surgical approaches adapted from other species. These include an interdental wire and acrylic splinting technique for repairing jaw fractures, the use of piezoelectric surgery to remove an ossifying fibroma, and a successful single-stage correction of the congenital deformity known as "wry nose".
A large multicentre study involving more than 1,600 horses from 19 equine clinics provides valuable new information on the presentation, diagnosis and prognosis of sinonasal disease, offering clinicians stronger evidence on which to base treatment decisions and discussions with owners.
The Special Focus Issue also addresses practical aspects of equine dentistry. One paper reports that elderly horses undergoing tooth extraction do not experience higher complication rates than younger animals, challenging a common assumption that advanced age alone increases surgical risk. Other studies examine techniques for oral tooth extraction and investigate emerging endodontic (root canal) treatments. While current evidence suggests that single-stage endodontic procedures may not completely eliminate infection in severely diseased teeth, researchers report encouraging early results using a novel calcium silicate cement for restoring treated teeth.
Education is another theme running through the collection. One study reviews equine dental teaching in veterinary schools and concludes that there is considerable scope to strengthen undergraduate training, helping future veterinarians develop the skills needed to manage these common conditions.
Barnett believes the Special Focus Issue represents one of the most comprehensive collections of research on equine dental and sinus disease published to date. He hopes it will advance understanding of these often-overlooked conditions and ultimately improve the health, welfare and quality of life of affected horses.
The Special Focus Issue is available here:
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